| NPI | 1750827549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: ID NS102890G) |
| Additional Taxonomies | 343800000X Secured Medical Transport (VAN) (Licence: ID NS102890G) |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2017-01-17 |